Noninvasive positive-pressure ventilation in children with lower airway obstruction*

Thill, Peter J.; McGuire, John K.; Baden, H; Green, Thomas P.; Checchia, Paul A.

doi:10.1097/01.pcc.0000128670.36435.83

Cited by 148 publications

(86 citation statements)

References 21 publications

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“…After two hours, treatment between the groups was inverted (crossover): Group 1 began to receive only conventional treatment and Group 2 received NIV in addition to conventional treatment. There was significant improvement in respiratory rate (p < 0.0001) and CAS (p < 0.0001) in the NIV group (10) . In the study by Villanueva, the effects of NIV were evaluated in 23 patients with hypoxemic respiratory insufficiency, hypercapnia, or postextubation respiratory insufficiency.…”

Section: Stregth Of Recommendationmentioning

confidence: 94%

“…The clinical evaluation of the benefits of NIV was performed by means of a randomized clinical trial with the general pediatric population (17) and a trial in the subpopulation with asthma (10) . Such studies were not completely appropriate since they did not compare NIV with the invasive treatment, but with conventional treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Author Study (n) Year of publication Population Akingbola et al (4) Case report (2) 1993 Children with atelectasis Fortenberry et al (5) Case series (28) 1995 Children with ARF Padman et al (6) Case series (34) 1998 Patients aged between 6 months and 18 years with ARF Sprague et al (7) Case series (5) 2000 Patients aged between 12 years and 18 years with ARF secondary to cystic fibrosis Akingbola et al (8) Case report (3) 2002 Children with asthma and hypercapnia Shah et al (9) Systematic review 2003 Children with bronchiolitis in ARF Thill et al (10) Randomized crossover clinical trial (16) 2004 Children with lower airways obstruction Piastra et al (11) Case series (4) 2004 Children aged between 9 and 17 years with acute leukemia and hypoxemic ARF Villanueva et al (12) Case series (23) 2005 Hypoxemic and hypercapnic ARF or respiratory failure after extubation Chin et al (13) Case series (15) 2005 Children aged 5 months and 14 years, submitted to liver transplant, that progressed with ARF and atelectasis Prado et al (14) Case series (14) 2005 Children aged between 1 month and 13 years, with ARF, reduced oxygenation (saturation < 93% with FiO2 > 40%) and ventilation (pH < 7,25), besides radiological impairment Carroll e Schramm (15) Case series (5) 2006 Children aged between 2 years and 18 years, with acute asthma, hypoxemia and increased respiratory work Essouri et al (16) Retrospective cohort (114 (20) Retrospective study 2007 Twenty patients with mean ages of 7.4 years, with ARF, received NIV and were divided into two groups for analysis: hypoxic and hypercapneic group. Codazzi et al (21) Case series (15) 2006 Fifteen children from 1 month to 5 years with hypoxemic ARF Piastra et al hypoxic group and hypercapnic group.…”

Section: Stregth Of Recommendationmentioning

confidence: 99%

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Noninvasive ventilation for acute respiratory failure in children – a systematic review

Gonzaga

Silva

Alonso

et al. 2011

Einstein (São Paulo)

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Objective: To assess the role of noninvasive ventilation in the treatment of children with acute respiratory failure. Methods: A systematic review of literature on noninvasive ventilation in MEDLINE, LILACS, EMBASE, and Cochrane databases, besides references in articles. The outcomes evaluated were responses in blood oxygenation and ventilation, and patient survival. Results: A total of 120 studies on noninvasive ventilation were found as of May, 2010. Of these, only 19 were about noninvasive ventilation in children. On the other hand, there are prospective and cohort clinical trials leading to a level II quality of evidence concerning the use of noninvasive ventilation in children. Conclusion: There is scientific evidence for proposing the use of noninvasive ventilation, with a B-II degree of recommendation. Keywords

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Section: Stregth Of Recommendationmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Stregth Of Recommendationmentioning

confidence: 99%

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Noninvasive ventilation for acute respiratory failure in children – a systematic review

Gonzaga

Silva

Alonso

et al. 2011

Einstein (São Paulo)

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“…Çocuklarda noninvazif MV uygulaması ile ilgili bilgiler sınırlıdır. 3,4 Çocuklarda noninvazif MV uygulaması için yüksek akımlı nazal kanül oksijenasyon (YANKO) tedavisi, son yıllarda hem dünyada hem de ülkemizde giderek artan kullanım alanı bulmuş bir tedavi yöntemidir. İlk önceleri preterm yenidoğanlarda uygulanmaya başlanan bu tedavinin zamanla yoğun bakımlar, çocuk ve erişkin acil servisler ve diğer servislerde de sıklıkla uygulanmaya başlandığı görülmektedir.…”

Section: Introductionunclassified

A Case of Pneumothorax due to High-Flow Nasal Cannula Oxygen Therapy

Konca¹,

Apaydın²,

Geyik³

2017

cayd

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Solunum yetmezliği bulguları olan hastalarda invazif ve noninvazif mekanik ventilasyon (MV) uygulamaları kullanılmaktadır. Noninvazif MV, son yıllarda çocuk yoğun bakım ünitelerinde kullanımı giderek artan bir uygulamadır. Bu amaçla yüksek akımlı nazal kanül oksijenasyon tedavisi (YANKO), giderek artan kullanım alanı bulmuş bir tedavi yöntemidir. Bu yöntemin avantajlarını bildiren çok sayıda çalışmaya rağmen; istenmeyen durumların gözlenebileceğini bildiren az sayıda çalışma bulunmaktadır. Bu çalışmada, YANKO almakta iken pnömotoraks gelişen 3 aylık bebek literatüre katkı sunmak amacıyla sunuldu. Anahtar Kelimeler: Çocuk, yüksek akım nazal kanül, pnömotoraks, yoğun bakım, yüksek akımlı oksijenizasyon Invasive and noninvasive mechanical ventilation (MV) applications are used for patients with respiratory insufficiency. Noninvasive MV has been increasingly used in pediatric intensive care units in recent years. For this purpose, high-flow nasal cannula (HFNC) oxygen therapy is a treatment method that has been increasingly used. Despite the numerous studies reporting the advantages of this method, there are also a few studies reporting that undesirable conditions can be observed. In this paper, in order to contribute to the literature, we present a 3-month-old baby who developed pneumothorax during HFNC implementation. Keywords: Child, high-flow nasal cannula, intensive care, pneumothorax Öz Abstract GirişAlt solunum yolu enfeksiyonları, dünya genelinde çocuklarda morbidite ve mortalitenin önde gelen nedenlerindendir. 1 Yatış süresinin, morbidite ve mortalite oranlarının azaltılabilmesi için bronşiyolit ve pnömonili çocuklarda oluşabilecek hipoksinin en kısa sürede giderilmesi gerekir. Solunum yetmezliği bulguları olan hastalarda bu amaçla invazif ve noninvazif mekanik ventilasyon (MV) uygulamaları kullanılmaktadır. İnvazif MV ile ilişkili dezavantajlar ve komplikasyon riskinin fazla olması nedeni ile noninvazif MV daha çok tercih edilir olmaya başlamıştır.2 Literatürde, noninvazif MV ile ilgili önerilerin büyük kısmı erişkin çalışmalarına dayanmaktadır. Çocuklarda noninvazif MV uygulaması ile ilgili bilgiler sınırlıdır.3,4 Çocuklarda noninvazif MV uygulaması için yüksek akımlı nazal kanül oksijenasyon (YANKO) tedavisi, son yıllarda hem dünyada hem de ülkemizde giderek artan kullanım alanı bulmuş bir tedavi yöntemidir. İlk önceleri preterm yenidoğanlarda uygulanmaya başlanan bu tedavinin zamanla yoğun bakımlar, çocuk ve erişkin acil servisler ve diğer servislerde de sıklıkla uygulanmaya başlandığı görülmektedir. [5][6][7] Bu tedavi yönteminin erken verilmesinin çocuk yoğun bakım ünitesi (ÇYBÜ) ihtiyacında azalma sağladığı ve bunu değerlendirmede ilk 1 saatteki kalp hızı ve solunum sayısı izleminin etkin olduğunu gösteren çalışmalar mevcuttur. 8 Ayrıca bu tedavi yönteminin nazal CPAP ile kıyaslandığı çalışmalarda tedavi başarısızlığı, pnömotoraks, intraventriküler kanama ve asidoz gibi komplikasyonlar açısından anlamlı bir farklılık yaratmadığı bildirilmektedir.9 Bu yöntemin avantajlarını bildiren çok sayıda çalışma...

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“…[1][2][3][4][5][6][7][8][9][10] Several studies have described the effectiveness of NIV in pediatric patients affected by exacerbation of chronic respiratory failure, due to restrictive chest wall deformities and neuromuscular diseases, 3,4 as well as in children with pneu-monia, 5,6 pulmonary edema, 7 cystic fibrosis, 8 and status asthmaticus. 9,10 NIV is usually delivered to pediatric patients during the acute phase in pressure support ventilation (PSV) with different interfaces such as a face mask and, in the past several years, a helmet. Compared with adults, children have a relatively higher breathing frequency, which can adversely affect patient-ventilator synchrony during PSV.…”

Section: Introductionmentioning

confidence: 99%

Influence of Different Interfaces on Synchrony During Pressure Support Ventilation in a Pediatric Setting: A Bench Study

Conti

Gregoretti²,

Spinazzola

et al. 2015

Respir Care

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BACKGROUND: In adults and children, patient-ventilator synchrony is strongly dependent on both the ventilator settings and interface used in applying positive pressure to the airway. The aim of this bench study was to determine whether different interfaces and ventilator settings may influence patient-ventilator interaction in pediatric models of normal and mixed obstructive and restrictive respiratory conditions. METHODS: A test lung, connected to a pediatric mannequin using different interfaces (endotracheal tube [ETT], face mask, and helmet), was ventilated in pressure support ventilation mode testing 2 ventilator settings (pressurization time [Time press ] 50% /cycling-off flow threshold [Tr exp ] 25% , Time press80% /Tr exp60% ), randomly applied. The test lung was set to simulate one pediatric patient with a healthy respiratory system and another with a mixed obstructive and restricted respiratory condition, at different breathing frequencies (f) (30, 40, and 50 breaths/min). We measured inspiratory trigger delay, pressurization time, expiratory trigger delay, and time of synchrony. RESULTS: At each breathing frequency, the helmet showed the longest inspiratory trigger delay compared with the ETT and face mask. At f 30 , the ETT had a reduced T press . The helmet had the shortest T press in the simulated child with a mixed obstructive and restricted respiratory condition, at f 40 during Time press50% /Tr exp25% and at f 50 during Time press80% /Tr exp60% . In the simulated child with a normal respiratory condition, the ETT presented the shortest T press value at f 50 during Time press80% /Tr exp60% . Concerning the expiratory trigger delay, the helmet showed the best interaction at f 30 , but the worst at f 40 and at f 50 . The helmet showed the shortest time of synchrony during all ventilator settings. CONCLUSIONS: The choice of the interface can influence patient-ventilator synchrony in a pediatric model breathing at increased f, thus making it more difficult to set the ventilator, particularly during noninvasive ventilation. The helmet demonstrated the worst interaction, suggesting that the face mask should be considered as the first choice for delivering noninvasive ventilation in a pediatric model.

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Noninvasive positive-pressure ventilation in children with lower airway obstruction*

Abstract: We conclude that noninvasive ventilation can be an effective treatment for children with acute lower airway obstruction.

Cited by 148 publications

References 21 publications

Noninvasive ventilation for acute respiratory failure in children – a systematic review

Noninvasive ventilation for acute respiratory failure in children – a systematic review

A Case of Pneumothorax due to High-Flow Nasal Cannula Oxygen Therapy

Influence of Different Interfaces on Synchrony During Pressure Support Ventilation in a Pediatric Setting: A Bench Study

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